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Safety and tolerability of once-daily tiotropium Respimat® as add-on to at least inhaled corticosteroids in adult patients with symptomatic asthma: A pooled safety analysis - 29/08/16

Doi : 10.1016/j.rmed.2016.07.001 
Ronald Dahl a, , Michael Engel b, Daniel Dusser c, David Halpin d, Huib A.M. Kerstjens e, Liliana Zaremba-Pechmann f, Petra Moroni-Zentgraf b, i, William W. Busse g, Eric D. Bateman h
a Odense University Hospital, University of Southern Denmark, Sdr Boulevard, DK 5000, Odense C, Denmark 
b TA Respiratory Diseases, Boehringer Ingelheim Pharma GmbH & Co. KG, Binger Str. 173, 55216, Ingelheim, Germany 
c Pulmonary Department and Adult Cystic Fibrosis Center, Paris Descartes University, Sorbonne Paris Cité, Cochin Hospital, 27 Rue du Fg St Jacques, 75014, Paris, France 
d Royal Devon & Exeter Hospital, Barrack Rd, Exeter, Devon, EX2 5DW, UK 
e University of Groningen, Department of Pulmonary Medicine, and Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, Postbox 30.001, 9700 RB, Groningen, The Netherlands 
f Global Biometrics and Data Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorferstrasse 65, 88397, Biberach an der Riss, Germany 
g University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792, Wisconsin, USA 
h Department of Medicine, University of Cape Town, Mowbray, 7700, Cape Town, South Africa 
i Boehringer Ingelheim Pty Limited, Level 1, 78 Waterloo Rd, North Ryde, NSW 2113, Australia 

Corresponding author.

Abstract

Background

Tiotropium, a long-acting anticholinergic bronchodilator, has demonstrated efficacy and safety as add-on therapy to inhaled corticosteroids (ICS), with or without other maintenance therapies, in patients with symptomatic asthma.

Objective

To evaluate safety and tolerability of tiotropium delivered via the Respimat® device, compared with placebo, each as add-on to at least ICS therapy, in a pooled sample of adults with symptomatic asthma at different treatment steps.

Methods

Data were pooled from seven Phase II and III, randomised, double-blind, parallel-group trials of 12–52 weeks’ treatment duration, which investigated once-daily tiotropium Respimat® (5 μg, 2.5 μg) versus placebo as add-on to different background maintenance therapy including at least ICS. Adverse events (AEs) including serious AEs were assessed throughout treatment + 30 days after the last dose of trial medication.

Results

Of 3474 patients analysed, 2157 received tiotropium. The percentage of patients with AEs was comparable between treatment groups: tiotropium 5 μg, 60.8%; placebo 5 μg pool, 62.5%; tiotropium 2.5 μg, 57.1%; placebo 2.5 μg pool, 55.1%. Consistent with the disease profile, the most frequent AEs overall were asthma, decreased peak expiratory flow rate (both less frequent with tiotropium) and nasopharyngitis. Overall incidence of dry mouth, commonly associated with use of anticholinergics, was low: tiotropium 5 μg, 1.0%; placebo 5 μg pool, 0.5%; tiotropium 2.5 μg, 0.4%; placebo 2.5 μg pool, 0.5%. The percentage of cardiac disorder AEs was comparable between tiotropium and placebo: tiotropium 5 μg, 1.4%; placebo 5 μg pool, 1.4%; tiotropium 2.5 μg, 1.4%; placebo 2.5 μg pool, 1.1%. The proportions of patients with serious AEs were balanced across groups: tiotropium 5 μg, 4.0%; placebo 5 μg pool, 4.9%; tiotropium 2.5 μg, 2.0%; placebo 2.5 μg pool, 3.3%.

Conclusion

Tiotropium Respimat® demonstrated safety and tolerability comparable with those of placebo, as add-on to at least ICS therapy, at different treatment steps in adults with symptomatic asthma.

El texto completo de este artículo está disponible en PDF.

Highlights

Tiotropium Respimat® demonstrated safety and tolerability comparable with placebo.
Incidence of adverse events and serious adverse events was similar between groups.
Overall incidence of dry mouth, common with anticholinergic use, was low.
Low number of cardiac disorder adverse events, comparable between groups.
No deaths occurred during any of the trials.

El texto completo de este artículo está disponible en PDF.

Keywords : Asthma, Respimat®, Safety, Tiotropium, Tolerability


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© 2016  The Authors. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 118

P. 102-111 - septembre 2016 Regresar al número
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